Next Time, Try Real Reform

Health Care: Wasn't the spending curve supposed to bend down? Isn't that what we were promised when the president and his party set out to maul our medical care system. So why will spending double by 2020?

Congress needed to pass the Democrats' health care "reform" because the law would bend the cost curve downward, Obama frequently said while campaigning for the Patient Protection and Affordable Care Act.

But the president's promise won't translate into reality.

According to the Centers for Medicare and Medicaid Services, under ObamaCare, health care spending will grow by 5.8% a year through 2020. That's 1.1 percentage points faster than it would grow if Washington had done nothing.

This means that our health care spending will grow from 17.6% of the economy in 2009 to 19.8% in 2020, when total expenditures will be more than $4 trillion.

So what did Obama know and when did he know it about the Patient Protection and Affordable Care Act? It's hard to believe he wasn't aware from the beginning that the law would increase costs. If he didn't know it, then he's not intellectually fit to be president. If he did know that costs would increase, yet continued to say the legislation would cut costs, he's morally unfit for the office he occupies.

Either way, he needs to be doing something else.

The next resident of the White House will need to move hard toward real reform that will cut medical spending and at the same time improve care. It won't require genius. There are ample proposals out there that will do both. They just need to be turned into law.

One of the better ideas is health savings accounts. Rather than buy comprehensive health care plans for their employees, companies could deposit cash into personal accounts used to pay medical costs. In the event of a catastrophic health event, a high-deductible, low-premium insurance plan provided by the employer would cover the costs.

Because Americans are so heavily insured, they are insulated from the costs of their health care. This encourages them to visit the doctor when they otherwise wouldn't if the payment was coming straight out of their pockets. The increased demand forces up prices.

HSAs, on the other hand, lower demand as patients become consumers. Because it's their money in the accounts, and unused dollars are rolled over, they have a strong incentive to self-ration their treatment.

Health Care: Wasn't the spending curve supposed to bend down? Isn't that what we were promised when the president and his party set out to maul our medical care system. So why will spending double by 2020?

Congress needed to pass the Democrats' health care "reform" because the law would bend the cost curve downward, Obama frequently said while campaigning for the Patient Protection and Affordable Care Act.

But the president's promise won't translate into reality.

According to the Centers for Medicare and Medicaid Services, under ObamaCare, health care spending will grow by 5.8% a year through 2020. That's 1.1 percentage points faster than it would grow if Washington had done nothing.

This means that our health care spending will grow from 17.6% of the economy in 2009 to 19.8% in 2020, when total expenditures will be more than $4 trillion.

So what did Obama know and when did he know it about the Patient Protection and Affordable Care Act? It's hard to believe he wasn't aware from the beginning that the law would increase costs. If he didn't know it, then he's not intellectually fit to be president. If he did know that costs would increase, yet continued to say the legislation would cut costs, he's morally unfit for the office he occupies.

Either way, he needs to be doing something else.

The next resident of the White House will need to move hard toward real reform that will cut medical spending and at the same time improve care. It won't require genius. There are ample proposals out there that will do both. They just need to be turned into law.

One of the better ideas is health savings accounts. Rather than buy comprehensive health care plans for their employees, companies could deposit cash into personal accounts used to pay medical costs. In the event of a catastrophic health event, a high-deductible, low-premium insurance plan provided by the employer would cover the costs.

Because Americans are so heavily insured, they are insulated from the costs of their health care. This encourages them to visit the doctor when they otherwise wouldn't if the payment was coming straight out of their pockets. The increased demand forces up prices.

HSAs, on the other hand, lower demand as patients become consumers. Because it's their money in the accounts, and unused dollars are rolled over, they have a strong incentive to self-ration their treatment.

Democrats have blocked widespread use of HSAs whenever possible. If they were more widely used, the sharp increase in costs would level off.

Dropping health insurance mandates would also bring significant savings. There are, for example, more than 2,000 state mandates that require plans to carry additional coverage beyond the basics of health care insurance. These regulation regimes push premium costs higher by 20%, according to the Council for Affordable Health Insurance.

When fully implemented, ObamaCare will have its own regulatory regime, and it will come at a steep price. The Congressional Budget Office said in November 2009 that the legislation that became ObamaCare would raise premiums by 30%.

Though fewer mandates would cut costs, the administration added another requirement this week. The Health and Human Services Department says that beginning on Jan. 1, 2013, insurers will have to provide birth control coverage and will be barred from requiring the "patient" to be responsible for a co-payment or a deductible.

The media are reporting that the birth control coverage will be free. But it won't be. It will be paid for through higher premiums, with the cost socialized throughout the customer base, much of which has no need for birth control.

Congress can also bring down costs by using the Constitution's commerce clause for good (removing barriers to interstate commerce) rather than ill (citing it as the foundation for ObamaCare's individual mandate).

While group health coverage can be bought across state lines, sale of individual plans across state lines is blocked in all but a few states. Removing these barriers would create a national market for individual plans, which would produce intense competition, which always benefits consumers.

Congress can't make laws in the states. But it could use the commerce clause, which was included in the Constitution to prevent states from impeding the flow of interstate trade, to pass legislation that would invalidate state laws that erect the trade barriers.

Republicans have tried before to pass legislation that would allow interstate sales, but they've been unable to get enough support from the party that forced the unwanted ObamaCare law onto the country.

Other federal policy changes would increase choice and bring down spending, including tort reform that would decrease the malpractice insurance costs that doctors pass on to patients.

All should be considered. The country needs consumer-driven care rather than a government-dictated structure. Health care is too important to be left in the hands of politicians and bureaucrats.

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